Provider Demographics
NPI:1063865418
Name:PHILIPPE NOEL MD AND ANNA BERENSTEIN MD PA
Entity Type:Organization
Organization Name:PHILIPPE NOEL MD AND ANNA BERENSTEIN MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:BERENSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:516-448-6600
Mailing Address - Street 1:4154 FAIRWAY PL
Mailing Address - Street 2:
Mailing Address - City:NORTH PORT
Mailing Address - State:FL
Mailing Address - Zip Code:34287-6118
Mailing Address - Country:US
Mailing Address - Phone:516-448-6600
Mailing Address - Fax:941-827-2932
Practice Address - Street 1:5400 S BISCAYNE DR
Practice Address - Street 2:B
Practice Address - City:NORTH PORT
Practice Address - State:FL
Practice Address - Zip Code:34287-1932
Practice Address - Country:US
Practice Address - Phone:516-448-6600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-21
Last Update Date:2016-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty